Steroid therapy.
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Adrenal Cortex Hormones↗
Biomedical subjects
K Brown
Publications and source records attributed to K Brown.
Health checks on patients 75 years and over in Nottinghamshire after the new GP contract.
OBJECTIVE: To investigate annual health checks for patients of 75 years and over required by the 1990 contract for general practitioners. DESIGN: Visits to practices to collect information on how assessments were organised and carried out; completion of questionnaires for every patient who had been assessed in a sample month, using information provided by the practice records. SETTING: 20 general practices in one family health services authority. SUBJECTS: Patients of 75 years and over in 20 general practices. RESULTS: Three practices (15%) had not performed checks. Thirteen practices sent a letter to invite patients to undergo a check. Of these practices, seven followed up non-responders. Two practices visited patients' homes unannounced, and two did checks on an opportunistic basis only. Sixteen practices used a checklist. Sixteen practices involved their practice nurses; at eight of these, doctors also performed checks; in six practices the nurses undertaking the checks had no training in assessing old people. Ten practices assessed more than 75% of their old people in the first year of the new contract. Practices that did not follow up patients who had not responded to the invitation for assessment completed significantly fewer checks. During the sample month, 331 patients were assessed in the 17 practices. 204 new problems were discovered in 143 patients. Significantly more problems per patient were found in inner city areas. CONCLUSIONS: The way health checks were performed varied greatly, both in their organisation and the practices' attitudes. Many old people did not respond to letters asking if they wanted an assessment but very few refused one if followed up. Forty three per cent of those assessed had some unmet need. The number of new problems found per patient may reduce over the next few years if the assessments are successful. The need for annual assessment should be kept under review and adequate resources made available for the needs uncovered. Improved training for practice nurses in assessment is needed. Effectiveness of the checks must be monitored. If most unmet need falls in particular high risk groups it would seem sensible to modify the annual check to target these groups.
Aged↗
Effect of H chain V region on complement activation by immobilized immune complexes.
Activation of C by immune complexes (IC) in tissues and the inflammatory consequences are major determinants in the pathogenesis of many autoimmune disorders. To assess the factors involved in C activation by such IC, we examined the binding of C components by chimeric IgG1 antibodies bound to immobilized Ag. We previously reported that alterations in the H chain V regions can affect the binding of first component of C (C1q) and a major breakdown product of the third C component (C3b) when otherwise identical antibodies were bound to immobilized (Tyr, Glu)-Ala-Lys. To evaluate C activation of these antibodies in well defined IC, we utilized a 9-amino acid peptide conjugated to BSA as Ag. The peptide:BSA conjugate was bound similarly by the two IgG1 antibodies which differed mainly in the CDR3 regions, but also in 9 other amino acids in the H chain V region. When soluble IC were prepared with the two antibodies, they activated C similarly. However, C activation by solid phase Ag:antibody complexes differed; we found that antibody 10B bound more C1q and C3b than antibody B11 did, unless the Ag was present at high density on the plates. These data suggest that the variable region differences affect C activation by these antibody when they are bound to immobilized Ag. Furthermore, these results underscore the differences in C activation by the same antibody depending upon whether the IC are free in solution or immobilized.
Amino Acid Sequence↗
Lymphocyte activation and the family of NF-kappa B transcription factor complexes.
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Animals↗
Smoking, nicotine dose and the lateralisation of electrocortical activity.
The effects of cigarette smoking on the balance of activity of the cerebral hemispheres were studied in two experiments. Experiment 1 examined the effects of smoking on lateralisation of EEG alpha and beta power in six male smokers, and revealed a dose-related biphasic action. Low doses of nicotine as measured by residual butt analysis increased left hemisphere activity in a dose related manner, while higher doses (greater than 1.1 mg) reversed this effect. Experiment 2 examined the time course of the changes in EEG alpha, beta, theta and delta lateralisation in 11 male smokers. During the initial period of smoking there was a reduction in EEG alpha, reflecting cortical activation, followed by an increased in alpha power towards the end of the cigarette. These changes were accompanied in smokers taking moderate nicotine doses, by an initial shift towards left hemisphere activation, followed by a reduction in left hemisphere activation relative to the right. Initial changes in delta and theta power were negatively correlated with nicotine dose. Higher nicotine doses were associated with greater shifts towards right hemisphere activation, as indicated by beta and delta lateralisation, and also with greater decreases in subjective arousal. These results were interpreted as supporting the hypothesis that the stimulant action of lower doses of nicotine involves the activation of a left hemisphere "Go" system, while the sedative effect of higher doses involves increased activation of the right hemisphere "NoGo" system.
Adult↗
A molecular and biochemical analysis of the structure of the cyanogenic beta-glucosidase (linamarase) from cassava (Manihot esculenta Cranz).
The cyanogenic beta-glucosidase (linamarase) of cassava is responsible for the first step in the sequential break-down of two related cyanoglucosides. Hydrolysis of these cyanoglucosides occurs following tissue damage and leads to the production of hydrocyanic acid. This mechanism is widely regarded as a defense mechanism against predation. A linamarase cDNA clone (pCAS5) was isolated from a cotyledon cDNA library using a white clover beta-glucosidase heterologous probe. The nucleotide and derived amino acid sequence is reported and five putative N-asparagine glycosylation sites are identified. Concanavalin A affinity chromatography and endoglycosidase H digestion demonstrate that linamarase from cassava is glycosylated, having high-mannose-type N-asparagine-linked oligosaccharides. Consistent with this structure and the extracellular location of the active enzyme is the identification of an N-terminal signal peptide on the deduced amino acid sequence of pCAS5.
Amino Acid Sequence↗
Shear strength of laboratory-processed composite resins bonded to a silane-coated nickel-chromium-beryllium alloy.
The shear bond strengths of three commercial laboratory curing composite resin veneers bonded to a nickel-chromium-beryllium alloy treated with the Silicoater system were evaluated. Two light-cured resins and one heat- and pressure-cured resin were evaluated. No statistically significant difference in bond strengths among the three resins was found. Microscopic analysis of the fracture surfaces indicated that all failures were complex and cohesive in nature within the resin and composite. On the basis of the shear bond strengths measured, any of the composite resin veneers tested appear to be clinically acceptable.
Acrylic Resins↗
Oral caffeine consumption by rats: the role of flavor history, concentration, concurrent food, and an adenosine agonist.
Some determinants of caffeine consumption by rats were examined using the two-bottle choice test. To describe the role of flavor history, groups of eight rats each received one of three fluids as their only source of fluid beginning at 29 days of age and continuing throughout the experiments. One group ("water") received tapwater, a second group ("caffeine") received 0.5 mg/ml caffeine in tapwater, and a third group ("quinine") received 0.01 mg/ml quinine in tapwater. Two-bottle choice tests began when rats were 40 days old. In the initial tests, caffeine rats drank more caffeinated water than water rats. Quinine rats were midway between these two groups. On a second block of tests, quinine and water rats' caffeine consumption increased so that the three groups were indistinguishable. When 0.5 mg/ml caffeine was available for 24 h, about one third of the total fluid consumption was of caffeinated water for all three groups. The presence of food greatly increased both caffeine and water consumption across a range of caffeine concentrations spanning 0.125-4.0 mg/ml. Increasing caffeine concentration generally increased consumption of plain water and decreased that of caffeinated water (but not total caffeine consumed) for water rats. Caffeine rats generally drank more caffeine than water rats, largely due to a tendency toward increased consumption of the 0.5-mg/ml concentration. Consumption of caffeinated water peaked at 0.5 mg/ml and showed graded decreases at higher and lower concentrations. Caffeine consumption showed dose-related increases with presession administration of l-phenylisopropyl adenosine. The serines of experiments characterize some of the determinants of caffeine consumption in rats.(ABSTRACT TRUNCATED AT 250 WORDS)
Adenosine↗
Social support and depression in men during alcoholism treatment.
Psychiatric comorbidities have been shown to be important predictors of the outcome of alcoholism treatment. This study examines whether perceived lack of social support can be identified as an independent predictor of symptoms of depression experienced during alcoholism treatment over and above the effects of personality characteristics and the severity of alcohol and psychiatric history. We studied 189 alcoholic men in treatment at a rural midwestern Department of Veterans Affairs medical center. Multiple regression analyses found that reduced social support significantly predicted depression (measured by the Beck Depression Inventory) during treatment while controlling for personality characteristics and the alcoholism and psychiatric subscales of the Addiction Severity Index. Although self-esteem, neuroticism, and psychiatric severity also were significantly associated with depression in the hierarchical regression model, social support demonstrated the strongest unique contribution to depression of any of the predictors. These results suggest that social support has an independent association with depression and perhaps may play an important role in improving treatment compliance and the outcome of alcoholism treatment.
Adult↗
Psychosocial responses among individuals with human immunodeficiency virus infection.
The purpose of this research was to identify and describe psychosocial responses to being infected with human immunodeficiency virus (HIV). Ten adults infected with HIV were interviewed and audiotaped as they described their feelings and experiences as HIV-infected people. The interviews were analyzed using a grounded theory methodology. The core category that emerged from the data was Fighting to Survive with HIV Infection. Supporting concepts were Taking Care and Restructuring One's Life. The concept of Taking Care included processes of everyday work and illness work. The processes involved in Restructuring One's Life were living with uncertainty, accepting homosexuality, experiencing changing feelings, protecting confidentiality, dealing with the medical profession, handling multiple losses, and living with a terminal illness.
Adaptation, Psychological↗
Differential morphologic and metabolic alterations in permissive versus nonpermissive murine macrophages infected with Legionella pneumophila.
Legionella pneumophila infection of macrophages from permissive guinea pigs and from A/J mice compared with infection of cells from nonpermissive BDF1 mice was studied by electron microscopy. The cells from the BDF1 mice were nonpermissive for legionella growth in vitro and showed few if any bacteria in phagosomes by electron microscopic examination. Similar electron micrographic examination of macrophages from A/J mice permissive for legionella growth showed numerous intact intracellular bacteria within 24 to 48 h of culture and the transition of intracellular bacteria from localization in a few large vacuoles early in the course of infection to later localization in areas surrounded and studded by ribosomes. These electron microscopic observations were similar to those seen in the case of guinea pig macrophages infected with legionellae. Biochemical studies of macrophages from permissive versus nonpermissive animals showed little or no differences in respiratory burst and lysosomal enzyme activity for macrophages from all animals tested. However, when zymosan was used as a stimulant, macrophages from the nonpermissive mouse strain produced a larger amount of H2O2 and O2- than did cells from permissive guinea pigs or A/J mice. However, legionella vaccine itself induced no detectable or very little H2O2 and O2- in macrophages tested from any source. These results suggest that permissiveness of A/J mouse macrophages to legionella growth may involve mechanisms similar to those occurring in guinea pig macrophages in terms of morphologic and possibly even biochemical events. The relatively higher production of reactive oxygens by BDF1 mouse macrophages in response to zymosan correlated with nonpermissiveness for legionella growth, although further analysis is necessary to link these observations.
Animals↗
A novel mitogen-inducible gene product related to p50/p105-NF-kappa B participates in transactivation through a kappa B site.
A Rel-related, mitogen-inducible, kappa B-binding protein has been cloned as an immediate-early activation gene of human peripheral blood T cells. The cDNA has an open reading frame of 900 amino acids capable of encoding a 97-kDa protein. This protein is most similar to the 105-kDa precursor polypeptide of p50-NF-kappa B. Like the 105-kDa precursor, it contains an amino-terminal Rel-related domain of about 300 amino acids and a carboxy-terminal domain containing six full cell cycle or ankyrin repeats. In vitro-translated proteins, truncated downstream of the Rel domain and excluding the repeats, bind kappa B sites. We refer to the kappa B-binding, truncated protein as p50B by analogy with p50-NF-kappa B and to the full-length protein as p97. p50B is able to form heteromeric kappa B-binding complexes with RelB, as well as with p65 and p50, the two subunits of NF-kappa B. Transient-transfection experiments in embryonal carcinoma cells demonstrate a functional cooperation between p50B and RelB or p65 in transactivation of a reporter plasmid dependent on a kappa B site. The data imply the existence of a complex family of NF-kappa B-like transcription factors.
Amino Acid Sequence↗
Imaging techniques in the evaluation of pulmonary parenchymal neoplasms.
Conventional PA and lateral chest radiographs continue to be the initial examination of choice to evaluate patients who are suspected of having a pulmonary parenchymal neoplasm. A lung lesion can be characterized as probably benign or malignant based on its radiographic appearance (size, shape, margins, presence of calcification, cavitation or air bronchograms, growth rate). A spiculated or lobulated lesion greater than 3 cm in size that is noncalcified is highly suspicious for malignancy. A lung lesion less than 3 cm in size with smooth borders that appears noncalcified on conventional radiographs should be examined by CT, including densitometry to detect calcification or fat, which indicates benignity. In patients with known lung cancer, CT can help to stage the tumor by indicating hilar or mediastinal involvement, or distant metastases. Currently, MR imaging has a limited role, but can be used as a "problem solving" modality for selected cases in evaluating pulmonary parenchymal neoplasms.
Diagnosis, Differential↗
Recovering relationships: a feminist analysis of recovery models.
Two models of recovery based on the concepts of independence and interdependence are contrasted from a feminist perspective. Drawing on social and psychological analyses, the authors critique the overemphasis of independence as the goal of health care and instead advocate a more relational model of therapy that reinforces social and emotional connections between people. Two narratives from occupational therapy are used to illustrate the differing assumptions underlying these models. The authors discuss some of the structural and interactional barriers to the expression of interdependence in health care institutions. They suggest that through purposefully sharing practice experiences and instating collaborative, nonhierarchical models of organization, practitioners can begin to overcome these barriers.
Aged↗
Variable region differences affect antibody binding to immobilized but not soluble antigen.
We have examined the antigen binding characteristics of two chimeric IgG1 antibodies that differ only in the heavy chain variable region. Antibodies 10B and B11 were expressed from two different anti-(Tyr,Glu)-Ala-Lys murine VH genes joined to human IgG1 constant region genes in a murine anti-(Tyr,Glu)-Ala-Lys heavy chain loss variant hybridoma. The binding characteristics of the antibodies to (Tyr,Glu)-Ala-Lys and to a peptide conjugate, CYYYEEEEY:BSA, were measured in solution and solid phase assays. The antibodies exhibited similar affinities and binding characteristics when assayed in solution assays. However, when we measured binding of antibodies to immobilized antigens, we found that antibody affinity depended on the epitope density in the immobilized immune complexes. The binding of antibody 10B and of B11 to immobilized (Tyr,Glu)-Ala-Lys and to CYYYEEEEY:BSA were similar at high antigen density, but antibody B11 bound less well at lower antigen density. Fab fragments of 10B bound to immobilized (Tyr,Glu)-Ala-Lys and CYYYEEEEY:BSA, but Fab fragments of B11 did not bind to (Tyr,Glu)-Ala-Lys and bound less well to CYYYEEEEY:BSA than 10B Fabs.
Amino Acid Sequence↗
Impaired emotional health in children with mild reading disability.
Children with reading disabilities are at risk for emotional difficulties. There is some evidence that reading-disabled children with high socioeconomic status may be at risk of having low self-esteem. We conducted a preliminary study of the impact of reading disability on children's self-esteem and emotional health in a select group of mildly impaired reading disabled children with well-educated parents who were well informed about reading disabilities. We interviewed 28 healthy, preadolescent boys and girls with mean reading delay of 9.0 months and 39 comparable nonreading disabled children who formed the control group. Children and parents completed the Harter's Self-Perception Profile. Parents completed the Achenbach Child Behavior Checklist and Rand Mental Health Survey. We found that these mildly impaired reading-disabled children were more anxious and less happy than were nondisabled students despite having well-informed, well-educated parents (mean level of education = 17.0 years). Reading-disabled children considered themselves to be less competent scholastically, and their parents rated them as less competent than nondisabled children on all measures of self-esteem. These well-educated mothers tended to underrate their child's perceived scholastic competence. Controlling for behavior problems, Achenbach Child Behavior Checklist scores for social competence were lower for reading-disabled children. These findings suggest that the mildly impaired reading-disabled children with high socioeconomic status are at risk for low self-esteem and poor emotional health.
Adaptation, Psychological↗
Inappropriate reattendances in out-patient departments.
In an attempt to identify the number and characteristics of inappropriate reattendances at out-patient clinics, clinic doctors and patients in two specialties throughout a health district were given a questionnaire to complete on every patient attendance over one week. Four hundred and fifty-two patients were seen, and 293 were asked to reattend: in some 80 of the latter cases the clinic doctor felt that the GP could nevertheless manage the problem. These 'inappropriate' invitations to reattend were more likely to be given by junior hospital staff to long-standing patients of the clinic attending for monitoring purposes. The patients involved in these 'inappropriate' requests to reattend also tended to think that their GP could manage the problem. It is concluded that discharge policy needs to be made more explicit and training for juniors organized if out-patient resources are to be used most efficiently.
Health Services Misuse↗
Alcohol hepatotoxicity: a genotypic predisposition?
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Adult↗